Individual provider Active NPI

Kidest Babi, NP

  • Gerontology Nurse Practitioner
  • Los Angeles, CA
National Provider Identifier
1679728505
Registry record updated Apr 10, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Nurse PractitionerTaxonomy code 363LG0600X
License
NP11910 Issued in CA
Practice address
2010 Zonal Ave
Lacusc Medical Center Geriatric Opd3P22B
Los Angeles, CA 90033
Phone
(323) 226-3638
Fax
(323) 226-7429
NPI assigned
Nov 19, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 10, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gerontology Nurse Practitioner 363LG0600X NP11910 CA Primary

Addresses

Primary practice location

2010 Zonal Ave
Lacusc Medical Center Geriatric Opd3P22B
Los Angeles, CA 90033

Mailing address

2020 Zonal Ave RM 430
Los Angeles, CA 90089-0121
Phone (323) 409-3376

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130802000398 CA Order and Referring Only - Nurse Practitioner 5193966141

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
NP11910CAMDGerontology Nurse Practitioner

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1227052800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712707200000",
    "number": "1679728505",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2020 ZONAL AVE RM 430",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900890121",
            "telephone_number": "323-409-3376",
            "fax_number": "323-226-2791"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2010 ZONAL AVE",
            "address_2": "LACUSC MEDICAL CENTER GERIATRIC OPD3P22B",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "90033",
            "telephone_number": "323-226-3638",
            "fax_number": "323-226-7429"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BABI",
        "first_name": "KIDEST",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-11-19",
        "last_updated": "2024-04-10",
        "certification_date": "2024-04-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "CA",
            "license": "NP11910",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.